An Integrative Approach to Abdominal Pain

Author(s):  
Marika Alois ◽  
Terry Kit Selfe ◽  
Irene M. Estores

This chapter discusses abdominal pain in the context of functional gastrointestinal disease (FGID) and some chronic inflammatory bowel diseases, recognizing the huge burden it places on the health care system and emotional costs to patients and health care professionals. It presents a review of several modalities that include mind–body medicine practices, natural products, botanicals, manual and movement-based therapies, and pharmaceuticals that can be used as part of an integrative health plan for patients presenting with FGID and abdominal pain. It describes an integrative approach that weaves in concepts of patient-centered care, effective communication, empathic listening, mindfulness, and evidence-informed practice.

2018 ◽  
Vol 09 (03) ◽  
pp. 704-713 ◽  
Author(s):  
Reinhold Haux ◽  
Elske Ammenwerth ◽  
Sabine Koch ◽  
Christoph Lehmann ◽  
Hyeoun-Ae Park ◽  
...  

Background Holistic, ubiquitous support of patient-centered health care (eHealth) at all health care institutions and in patients' homes through information processing is increasingly supplementing institution-centered care. While eHealth indicators may measure the transition from institution-centered (e.g., hospital-centered) information processing to patient-centered information processing, collecting relevant and timely data for such indicators has been difficult. Objectives This article aims to design some basic eHealth indicators, which are easily collected and measure how well information processing supports holistic patient-centered health care, and to evaluate penetrance of patient-centered health as measured by the indicators internationally via an expert survey. Methods We identified six basic indicators that measure access of health care professionals, patients, and caregivers to the patient's health record data and the ability of providers, patients, and caregivers to add information in the patient's record. In a survey of international informatics experts, these indicators' penetrance were evaluated for Austria, Finland, Germany, Hong Kong, South Korea, Sweden, and the United States in the summer of 2017. Results The eHealth status measured by the indicators varied significantly between these seven countries. In Finland, most practices measured by the indicators were fully implemented whereas in Germany only one practice was partially realized. Conclusion Progress in the implementation of practices that support patient-centered care could mainly be observed in those countries where the “political will” focused on achieving patient-centered care as opposed to an emphasis on institution-centered care. The six eHealth indicators seem to be useful for measuring national progress in patient-centered care. Future work will extend the number of countries analyzed.


2013 ◽  
Vol 34 (1) ◽  
pp. E1 ◽  
Author(s):  
Rachel F. Groman ◽  
Koryn Y. Rubin

In an effort to rein in spending and improve patient outcomes, the US government and the private sector have adopted a number of policies over the last decade that hold health care professionals increasingly accountable for the cost and quality of the care they provide. A major driver of these efforts is the Patient Protection and Affordable Care Act of 2010 (ACA or Pub.L. 111–148), which aims to change the US health care system from one that rewards quantity to one that rewards better value through the use of performance measurement. However, for this strategy to succeed in raising the bar on quality and efficiency, it will require the development of more standardized and accurate methods of data collection and further streamlined federal regulations that encourage enhanced patient-centered care instead of creating additional burdens that interfere with the physician-patient relationship.


2020 ◽  
Vol 36 (3) ◽  
pp. 199-209 ◽  
Author(s):  
Samantha Thomas ◽  
Kate O’Loughlin ◽  
Jillian Clarke

Objective: To identify factors influencing sonographers’ practices in communicating adverse obstetric findings and to understand their views on the need for standardized national policies and guidelines. Methods: Qualified and trainee sonographers who currently perform obstetric sonography were invited to complete a survey through the Australasian Sonographers Association. Closed-ended questions sought information on the demographic profile of the participants and their experiences on a range of issues related to workplace practices and policies. Open-ended questions allowed respondents to elaborate on workplace interactions and their views on the communication roles of sonologists (radiologists and obstetricians) and sonographers. Results: The practice setting, the background of the sonologist, the type of adverse finding, and the trimester in which a patient is scanned have an impact on the level of difficulty for sonographers in obstetric communication. These findings highlight a lack of uniformity of sonographer and sonologist communication with patients due to limited training, lack of formalized departmental policies, inadequate support, and communication practices by radiologists. As a result, respondents strongly supported the development of a standardized national policy. Conclusion: In the current environment of patient-centered care, sonographers are in a challenging position as they do not have policies supporting them as independent health care professionals, autonomously deciding on the best approach to communicate findings with their patients. This may lead to anxiety and stress if they lack control over the interaction. More support from sonologists in a radiology setting is needed. These findings should encourage professional bodies to address these issues by working collaboratively and to recognize the importance of the sonographers’ role and their unique position with pregnant patients.


Author(s):  
James Blagg

A signal report of the Institute of Medicine (IOM) in 2003 stated that profound changes were needed in how health systems are designed, and postulated that such redesign could not take place without properly preparing health care professionals to take on this task. It established a set of core competencies (competence in patient-centered care, interdisciplinary teaming, evidence-based practice, quality improvement, and informatics) that future professionals should possess. The current study was conducted to determine the extent to which these core competencies have been incorporated into curricula by colleges/schools of allied health. A survey was e-mailed to 112 institutional representatives of the member institutions of the Association of Schools of Allied Health Professions for completion online. Thirty (26.8%) responded, and results were tabulated by Zoomerang software. Results indicated high desire to integrate the competencies and moderate to strong success in doing so. Most often, the competencies were included via integration throughout the curriculum, and rarely in standalone courses. This curriculum integrative approach makes sense, in the opinion of the author, as it has students apply the recommended competencies in concert with each other to various areas of content and scenarios rather than applying each in isolation within single standalone courses.


2021 ◽  
Vol 74 (2) ◽  
Author(s):  
Pedro Rodrigues Carvalho ◽  
Emannuela Sofia Dantas Ferraz ◽  
Cristiane Chagas Teixeira ◽  
Valéria Bertonha Machado ◽  
Ana Lúcia Queiroz Bezerra ◽  
...  

ABSTRACT Objectives: to analyze health professionals’ perception about the meaning and practice of patient involvement in care safety in Primary Health Care. Methods: this is an exploratory, qualitative study, developed with 22 professionals in the Federal District, Brazil. A semi-structured interview was conducted between October and November/2018. Content analysis was carried out according to Bardin. Results: nurses, physicians, dentists, among others, participated. The following categories emerged: Meaning of patient involvement in care safety; Factors intervening in patient involvement in care safety; Strategies for patient involvement in care safety; Qualification for patient involvement in care safety. Final Considerations: the meaning of patient involvement for care safety was associated with co-responsibility and patient-centered care. Professionals’ practice revealed intervening factors and the use of involvement strategies. A gap was identified in training on patient involvement in care safety.


2018 ◽  
Author(s):  
Ying-Li Lee ◽  
Yan-Yan Cui ◽  
Ming-Hsiang Tu ◽  
Yu-Chi Chen ◽  
Polun Chang

BACKGROUND Chronic kidney disease (CKD) is a global health problem with a high economic burden, which is particularly prevalent in Taiwan. Mobile health apps have been widely used to maintain continuity of patient care for various chronic diseases. To slow the progression of CKD, continuity of care is vital for patients’ self-management and cooperation with health care professionals. However, the literature provides a limited understanding of the use of mobile health apps to maintain continuity of patient-centered care for CKD. OBJECTIVE This study identified apps related to the continuity of patient-centered care for CKD on the App Store, Google Play, and 360 Mobile Assistant, and explored the information and frequency of changes in these apps available to the public on different platforms. App functionalities, like patient self-management and patient management support for health care professionals, were also examined. METHODS We used the CKD-related keywords “kidney,” “renal,” “nephro,” “chronic kidney disease,” “CKD,” and “kidney disease” in traditional Chinese, simplified Chinese, and English to search 3 app platforms: App Store, Google Play, and 360 Mobile Assistant. A total of 2 reviewers reached consensus on coding guidelines and coded the contents and functionalities of the apps through content analysis. After coding, Microsoft Office Excel 2016 was used to calculate Cohen kappa coefficients and analyze the contents and functionalities of the apps. RESULTS A total of 177 apps related to patient-centered care for CKD in any language were included. On the basis of their functionality and content, 67 apps were recommended for patients. Among them, the most common functionalities were CKD information and CKD self-management (38/67, 57%), e-consultation (17/67, 25%), CKD nutrition education (16/67, 24%), and estimated glomerular filtration rate (eGFR) calculators (13/67, 19%). In addition, 67 apps were recommended for health care professionals. The most common functionalities of these apps were comprehensive clinical calculators (including eGFR; 30/67; 45%), CKD medical professional information (16/67, 24%), stand-alone eGFR calculators (14/67, 21%), and CKD clinical decision support (14/67, 21%). A total of 43 apps with single- or multiple-indicator calculators were found to be suitable for health care professionals and patients. The aspects of patient care apps intended to support self-management of CKD patients were encouraging patients to actively participate in health care (92/110, 83.6%), recognizing and effectively responding to symptoms (56/110, 50.9%), and disease-specific knowledge (53/110, 48.2%). Only 13 apps contained consulting management functions, patient management functions or teleconsultation functions designed to support health care professionals in CKD patient management. CONCLUSIONS This study revealed that the continuity of patient-centered care for CKD provided by mobile health apps is inadequate for both CKD self-management by patients and patient care support for health care professionals. More comprehensive solutions are required to enhance the continuity of patient-centered care for CKD.


2017 ◽  
Vol 23 (2) ◽  
pp. 121-123
Author(s):  
Shirley A. Lucier

The failure of health care professionals and providers to recognize and discuss end-of-life care continues to resonate across our heath care continuum. The value of the patient–clinician interaction is paramount in advocating for and establishing effective communication and care.A meaningful nurse–patient relationship is a key component to facilitate discussion of patient and family choices in how care can be managed throughout the dying process. This article describes how, using Virginia Henderson’s nursing model of patient-centered care, a holistic and palliative approach to end-of-life care was successfully supported in the home.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Susan Edgman-Levitan ◽  
Stephen C. Schoenbaum

AbstractPatient centered care requires that health care organizations and health care professionals actively understand what patients value. Fortunately, there are methods for gaining that understanding. But, they need to be adopted much more widely, and patients need to be treated as full partners in their care.


2017 ◽  
Vol 35 (21-22) ◽  
pp. 4757-4778
Author(s):  
Debra Patterson ◽  
Megan Pennefather ◽  
Kathleen Donoghue

Sexual assault forensic examiners (SAFEs) have a complex role that entails providing health care and medical forensic evidence collection. The literature indicates that there are two orientations that guide SAFEs in this role. A patient-centered orientation emphasizes attending to emotional needs, offering options, and respecting survivors’ decisions, which has been linked to positive emotional outcomes. A prosecutorial orientation places emphasis on evidence collection and has been associated with providing fewer comprehensive services. SAFE training may play a pivotal role in guiding new SAFEs to adopt a patient-centered orientation. However, there is a paucity of research examining how training can bolster the adoption of this orientation. Thus, the current qualitative study explored if and how a national blended SAFE training influenced participants’ adoption of a patient-centered orientation. Semistructured qualitative interviews were conducted with 64 health care professionals who participated in a national SAFE training. Utilizing analytic induction, the results suggest that the majority of participants entered the training with a prosecutorial orientation but shifted to a patient-centered orientation. Multiple elements of the training influenced this shift including (a) content that dispelled misconceptions of survivors; (b) providing explanations of how attending to survivors’ well-being can lead to positive outcomes; (c) earlier placement of patient-centered content to allow instructors to explain how patient-centered care can be applied to each component of the SAFE role including the medical forensic exam; and (d) continual emphasis on patient-centered care.


10.2196/22744 ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. e22744
Author(s):  
Olivia Lounsbury ◽  
Lily Roberts ◽  
Jonathan R Goodman ◽  
Philippa Batey ◽  
Lenny Naar ◽  
...  

Background Evidence suggests that health care data sharing may strengthen care coordination, improve quality and safety, and reduce costs. However, to achieve efficient and meaningful adoption of health care data-sharing initiatives, it is necessary to engage all stakeholders, from health care professionals to patients. Although previous work has assessed health care professionals’ perceptions of data sharing, perspectives of the general public and particularly of seldom heard groups have yet to be fully assessed. Objective This study aims to explore the views of the public, particularly their hopes and concerns, around health care data sharing. Methods An original, immersive public engagement interactive experience was developed—The Can of Worms installation—in which participants were prompted to reflect about data sharing through listening to individual stories around health care data sharing. A multidisciplinary team with expertise in research, public involvement, and human-centered design developed this concept. The installation took place in three separate events between November 2018 and November 2019. A combination of convenience and snowball sampling was used in this study. Participants were asked to fill self-administered feedback cards and to describe their hopes and fears about the meaningful use of data in health care. The transcripts were compiled verbatim and systematically reviewed by four independent reviewers using the thematic analysis method to identify emerging themes. Results Our approach exemplifies the potential of using interdisciplinary expertise in research, public involvement, and human-centered design to tell stories, collect perspectives, and spark conversations around complex topics in participatory digital medicine. A total of 352 qualitative feedback cards were collected, each reflecting participants’ hopes and fears for health care data sharing. Thematic analyses identified six themes under hopes: enablement of personal access and ownership, increased interoperability and collaboration, generation of evidence for better and safer care, improved timeliness and efficiency, delivery of more personalized care, and equality. The five main fears identified included inadequate security and exploitation, data inaccuracy, distrust, discrimination and inequality, and less patient-centered care. Conclusions This study sheds new light on the main hopes and fears of the public regarding health care data sharing. Importantly, our results highlight novel concerns from the public, particularly in terms of the impact on health disparities, both at international and local levels, and on delivering patient-centered care. Incorporating the knowledge generated and focusing on co-designing solutions to tackle these concerns is critical to engage the public as active contributors and to fully leverage the potential of health care data use.


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